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Comparison of Three Different Fat Graft Preparation Methods: Gravity Separation, Centrifugation, and Simultaneous Washing with Filtration in a Closed System

Zhu, Min M.D.; Cohen, Steven R. M.D.; Hicok, Kevin C. M.S.; Shanahan, Rob K. B.S.; Strem, Brian M. Ph.D.; Yu, Johnson C. B.S.; Arm, Douglas M. Ph.D.; Fraser, John K. Ph.D.

Plastic and Reconstructive Surgery: April 2013 - Volume 131 - Issue 4 - p 873–880
doi: 10.1097/PRS.0b013e31828276e9
Cosmetic: Original Articles

Background: Successful long-term volume retention of an autologous fat graft is problematic. The presence of contaminating cells, tumescent fluid, and free lipid in the graft contributes to disparate outcomes. Better preparation methods for the fat graft before transplantation may significantly improve results.

Methods: Subcutaneous fat from 22 donors was divided and processed using various graft preparation methods: (1) no manipulation control, (2) gravity separation, (3) Coleman centrifugation, and (4) simultaneous washing with filtration using a commercially available system (Puregraft; Cytori Therapeutics, Inc., San Diego, Calif.). Fat grafts from various preparation methods were examined for free lipid, aqueous liquid, viable tissue, and blood cell content. Adipose tissue viability was determined by measuring glycerol release after agonist induction of lipolysis.

Results: All test graft preparation methods exhibited significantly less aqueous fluid and blood cell content compared with the control. Grafts prepared by washing with filtration exhibited significantly reduced blood cell and free lipid content, with significantly greater adipose tissue viability than other methods.

Conclusion: Washing with filtration within a closed system produces a fat graft with higher tissue viability and lower presence of contaminants compared with grafts prepared by alternate methods.

San Diego, Calif.

From Cytori Therapeutics, Inc., and University of California, San Diego, and Rady Children's Hospital.

Received for publication May 1, 2012; accepted November 1, 2012.

Disclosure:Dr. Zhu, Mr. Hicok and Mr. Shanahan, and Drs. Arm and Fraser are shareholders and employees of Cytori Therapeutics, Inc. Dr. Cohen is a shareholder and paid consultant for Cytori Therapeutics. Dr. Strem is a former employee of Cytori Therapeutics. Mr. Yu is an employee of Cytori Therapeutics. Cytori Therapeutics provided funding and technical and editorial support for this study.

John K. Fraser, Ph.D.; Cytori Therapeutics, Inc., 3020 Callan Road, San Diego, Calif. 92121,

©2013American Society of Plastic Surgeons